Infectious mononucleosis

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Última revisão: 11 Aug 2025

Última atualização: 13 Dec 2024

Infectious mononucleosis is characterized by the classic triad of fever, pharyngitis, and lymphadenopathy, along with atypical lymphocytosis. It is often subclinical in young children.

Caused by infection with Epstein-Barr virus (EBV) in 80% to 90% of cases. Positive serologic test for antibodies against EBV is usually diagnostic.

Rare but potentially life-threatening complications include severe upper airway obstruction, splenic rupture, fulminant hepatitis, encephalitis, severe thrombocytopenia, and hemolytic anemia.

Treatment is usually symptomatic.

Definição

Infectious mononucleosis (IM), also known as glandular fever, is a clinical syndrome most commonly caused by Epstein-Barr virus (EBV) infection in 80% to 90% of cases.[1][2] Other causes are much less common. The diagnosis "infectious mononucleosis" is primarily used when the syndrome is caused by EBV; "mononucleosis syndrome" should be used when the syndrome is caused by a non-EBV etiology. This topic focuses on IM caused by EBV.

IM typically manifests in adolescents and young adults as a febrile illness with sore throat and enlarged lymph nodes. Atypical lymphocytosis is usually observed. The disease is generally mild in children, but more severe in adults. Resolution of the acute illness is usually followed by a lifelong latent infection, with over 90% of the adult population infected worldwide.[3]

História e exame físico

Principais fatores diagnósticos

fever
pharyngitis
cervical or generalized lymphadenopathy
malaise

Detalhes completos

Outros fatores diagnósticos

splenomegaly
rash
signs of hepatitis (hepatomegaly, jaundice)
jaundice
myalgia

Detalhes completos

Fatores de risco

kissing
sexual behavior

Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

CBC
Epstein-Barr virus (EBV)-specific antibodies
LFTs

Detalhes completos

Tests to avoid

serum Monospot for EBV infection
ultrasonography of abdomen

Detalhes completos

Investigações a serem consideradas

real-time polymerase chain reaction (PCR)
CT of abdomen

Detalhes completos

Algoritmo de tratamento

AGUDA

all patients

Colaboradores

Autores

George Turabelidze, MD, PhD

Medical Epidemiologist

Missouri Department of Health and Senior Services

Adjunct Assistant Professor of Clinical Pediatrics

Washington University School of Medicine

St Louis

Declarações

GT declares that he has no competing interests.

Revisores

Linda Kalilani, MBBS, MPhil, PhD

Epidemiologist

College of Medicine

University of Malawi

Zomba

Malawi

Declarações

LK declares that she has no competing interests.

Paul G. Auwaerter, MD, MBA, FACP, FIDSA

Clinical Director

Division of Infectious Diseases

Associate Professor of Medicine

Divisions of Infectious Diseases and General Internal Medicine

Johns Hopkins University School of Medicine

Baltimore

Declarações

PGA declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

Vetsika EK, Callan M. Infectious mononucleosis and Epstein-Barr virus. Expert Rev Mol Med. 2004 Nov 5;6(23):1-16. Resumo

Katz BZ. Update on chronic fatigue syndrome and Epstein-Barr virus. Pediatr Ann. 2002 Nov;31(11):741-4. Resumo

Ganzel TM, Goldman JL, Padhya TA. Otolaryngologic clinical patterns in pediatric infectious mononucleosis. Am J Otolaryngol. 1996 Nov-Dec;17(6):397-400. Resumo

De Paor M, O'Brien K, Fahey T, et al. Antiviral agents for infectious mononucleosis (glandular fever). Cochrane Database Syst Rev. 2016 Dec 8;(12):CD011487.Texto completo Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.

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Infectious mononucleosis

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

Outros fatores diagnósticos

Fatores de risco

Investigações diagnósticas

Primeiras investigações a serem solicitadas

Tests to avoid

Investigações a serem consideradas

Algoritmo de tratamento

all patients

Colaboradores

Autores

George Turabelidze, MD, PhD

Declarações

Revisores

Linda Kalilani, MBBS, MPhil, PhD

Declarações

Paul G. Auwaerter, MD, MBA, FACP, FIDSA

Declarações

Peer reviewer acknowledgements

Disclosures

Referências

Principais artigos

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.

Diagnósticos diferenciais

Folhetos informativos para os pacientes

Videos

Conectar-se ou assinar para acessar todo o BMJ Best Practice

Conectar-se ou assinar para acessar todo o BMJ Best Practice

Conectar-se para acessar todo o BMJ Best Practice